Dr. Donohue: Most recover completely from pleurisy

Dr. Paul DonohueSyndicated Columnist

Published Sunday, May 04, 2008

DEAR DR. DONOHUE: Is pleurisy a lung disease? I have heard of it many times, but I never knew anyone who had it until my daughter came down with it. Can you elaborate on it? Does it leave any permanent damage? K.J.

ANSWER: To carry heavy groceries, you double-bag them. The pleura are the lungs' double bags. They keep the lungs in place, and they protect them. Between the two plies of pleurae is a small, well-lubricated space that allows for expansion and contraction of the lungs when air is drawn in and exhaled. Pleurisy is an inflammation of those adjacent pleural surfaces. It's not a lung disease, but it can sometimes come from a lung disease.

Chest pain is the principal pleurisy symptom. The pain increases on deep breathing and coughing, as the inflamed pleural surfaces rub against one another. Children with pleurisy tend to lie on the side of the chest where pleurisy has struck in order to limit chest and pleural movement.

The causes of pleurisy are many. Viruses are a major cause, and often a cause of childhood pleurisy. For most viral pleurisy, the only treatment is making the child as comfortable and pain-free as possible. The infection runs its course in a matter of weeks.

I don't want to make pleurisy sound as though it is a nothing illness. It can be quite serious. Sometimes it fills the space between the two pleurae with a large volume of fluid, which must be drained. That's a pleural effusion. Furthermore, adult pleurisy with pleural effusion can be a sign of cancer, heart failure or dangerous infections such as TB.

Your daughter, however, should not suffer any permanent consequences.

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DEAR DR. DONOHUE: What exactly is a staff infection? I have one and am on an antibiotic. I have heard that these infections are incurable and that antibiotics don't work for them. Is that true? It has me scared silly. A.E.

ANSWER: Staph is pronounced "staff," and I can understand how people would think "staff" is its spelling. Actually, it's a shortened version of Staphylococcus, a bacterium found just about everywhere. Many skin infections are staph infections. Boils are an example. The staph germ also can cause infections of the bones, muscles and internal organs, like the heart.

What you heard is wrong. Staph infections are curable, but the germ is a wily one. In the early days of antibiotics, penicillin cured all staph infections. The germ learned how to evade penicillin's killing action. Newer penicillins were devised to be effective against the resistant staph. One of those drugs was methicillin. Some staph learned how to dodge methicillin, and these are known as MRSA, methicillin-resistant staph aureus. MRSA is pronounced "mersa." MRSA staph are a problem, but we have antibiotics that work against them. You need not be scared silly.

The staph resistance story came about from the indiscriminate use of antibiotics. Antibiotics should be reserved only for bacterial infections.

DEAR DR. DONOHUE: How much fat is acceptable to eat a day? I weigh 180 pounds and am 6 feet tall.

Please don't ask why I want this information. I just need it. -- M.H.

ANSWER: OK. Why do you want this information?

Thirty percent of a person's daily calories are the maximum amount of calories that should come from fat. To roughly estimate the number of needed daily calories, multiply your current weight (if that's the weight you want to stay at) by 16 (kilograms by 35). You can eat 2,880 calories a day and stay at 180 pounds. Thirty percent of that number is 864 calories. That amounts to 96 grams (3.2 ounces) of fat.

Are you sure this information is going to be helpful? Most people need a concrete example of how much this number of grams looks like.